Abstract
Background: It is currently unknown whether young women (≤55 yrs) have a greater risk of all cause-re-hospitalization following AMI than similarly aged men. This is an important subgroup to study considering younger women’s higher post-AMI mortality compared with age-matched men. We determined if there are sex differences in the 1-year re-hospitalization rate, including factors associated with this outcome. Methods: Young AMI patients (N=1414, 28% women) were identified from the 24-center prospective, observational TRIUMPH study. Patient data was abstracted from medical records and health status was collected through interviews at the time of the AMI [Short Form 12 (SF-12), and the Seattle Angina Questionnaire (SAQ)]. Physicians adjudicated each re-hospitalization the year after discharge. We compared sexes using t-test/x2 and Cox proportional hazards analysis, sequentially adjusting for important covariates. Results: The crude 1-yr re-hospitalization rate was higher in women vs. men (32% vs. 23%, P<0.001), and women also had more hypertension (64% vs. 53%), diabetes (34% vs. 22%), lung disease (9% vs. 3%), and depression (14% vs. 6%; P<0.0001 for all). At presentation, women had worse general health scores (SF-12 physical summary=41±12 vs. 44±11, mental summary= 45±13vs.49±11, P<0.0001 for all), more angina (SAQ angina frequency=83±22 vs. 87±19), poorer physical function (SAQ physical limitation=82±24 vs. 89±19) and worse quality of life (57±23 vs. 62±23; P<0.001 for all). In the fully adjusted model, female sex was no longer significantly associated with 1-year re-hospitalization post AMI (HR=1.20, 95%CI = 0.93, 1.56). Conclusion: Young women have a higher crude rate of 1-year re-hospitalization post AMI compared with men, however this effect was attenuated following adjustment. In addition to conventional risk factors, health status/psychosocial issues may be contributing factors in the risk of re-hospitalization among these young patients.
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